Narrative of a Tragedy: Selling Organs to Survive
It is an undeniable fact that poverty, in addition to changing the economic conditions of a society, also affects the social life of citizens. The reduction in the purchasing power of citizens causes their previous social habits, such as allocating money for entertainment, proper clothing and food, health and treatment, to change, and as a result, a lifestyle is formed in which the goal is simply to provide basic needs, including a roof over their heads and a little food to survive.
With the spread of poverty and its increasing pressure on citizens, reducing spending on credit cards no longer meets the needs of the family, and people are forced to change their source of income or add a new source to meet their basic needs; because on the one hand, the purchasing power of previous income has decreased with the increase in the inflation rate, and on the other hand, economic conditions are such that an increase in income from the previous source of income is not expected.
In such economic conditions, it is certainly not possible to change the source of income through conventional and usual methods, such as trying to find a higher-paying job, because the labor market affected by the dire economic situation is unable to attract higher-paying labor. Therefore, the only way forward to maintain the current so-called "eat and die" situation is to increase income through unusual, unhealthy, but at the same time legal methods; methods that are referred to among socio-economic researchers as "false jobs"; jobs that, although not prohibited by the laws of their societies, their creation and expansion are directly related to the spread of poverty in society and are becoming widespread at the same rate and speed.
The direct relationship between poverty and organ trafficking in Iran
The role of poverty in the spread of fake jobs, especially the sale of body parts in Iran, is undeniable. A look at the economic statistics for this year (1400) shows that the economic situation of Iranians this year is still on the decline, as it was four years ago, and the resulting poverty has increased. In this context, Mohammad Reza Pourabrahimi, the head of the Economic Commission of the Islamic Consultative Assembly in November 1400, confirmed the increase in the poverty rate compared to last year, considering it to be ten percent. According to him, the poverty index rate in Iran has increased from twenty-two percent last year to nearly thirty percent this year.
This figure, of course, does not match the official statistics provided, and it seems that the situation in Iran is worse than what this MP says, because according to a report published by the Ministry of Cooperatives, Labor and Social Welfare in August of this year, the 32% poverty rate is from 2019, when the inflation rate was about 35%. This means that in 2019, more than 26 million people in Iran were living below the poverty line and in absolute poverty.
This figure has certainly increased in 2020 with the increase in the inflation rate to 36.5 percent, and as a result, it seems that with inflation of 40 percent this year and a 38 percent increase in the poverty line last year alone, at least 36 million citizens in Iran are currently living in absolute poverty. This situation, in which meeting basic needs such as access to a place to live, safe drinking water, food, and medical care becomes a major and unattainable challenge for citizens, is the one that has the greatest potential for creating and expanding fake jobs, because the goal is simply to meet basic needs for survival, not living.
In addition to the economic statistics corroborating the spread of organ sales, this issue has even been confirmed by official authorities. In this context, Hossein Ali Shahriari, a member of the Health and Medical Commission of the Islamic Consultative Assembly in March 2016, considered citizens’ actions in selling their organs, especially kidneys, to be in line with the “resistance economy” and said: “When we talk about the resistance economy, the best thing is kidney transplantation; because it also reduces costs because dialysis is very expensive and a large number of machines must be purchased.” This then-Member of the Iranian Parliament also explicitly identified poverty as one of the factors influencing citizens’ willingness to sell their organs, saying: “What is wrong with a person doing this when he is living in poverty and his life changes by receiving twenty to thirty million?”
Is "selling" legally prohibited and "donating" free?
Some believe that the legal vacuum in the field of organ trafficking in Iran has not been ineffective in spreading this phenomenon, and that the issue of organ trafficking is not simply an economic issue arising from poverty; meaning that despite the explicit criminalization of buying and selling organs for organ transplantation in many countries, this issue is not mentioned in any way in Iranian criminal laws and is only mentioned in circulars from the Ministry of Health addressed to organ transplant associations and medical centers.
In this regard, according to a circular issued by the Deputy Health Minister of the Ministry of Health in October 1999, entitled “Guidelines for Kidney Donation and Transplantation from Living Donors,” addressed to all kidney transplant centers, it simply states that advertising and promoting “kidney donation” as well as “commercial mediation in the donation process” is prohibited and violators will be dealt with legally. In the meantime, apart from the fact that even the Ministry of Health circular refrains from using the word “sale” to express the prohibition, the main issue here is that according to the current criminal laws in Iran, there is basically no punishment for advertising and promoting kidney donation, and it is not clear on what legal basis the Ministry of Health’s threat of action was made.
On the other hand, the lack of explicit mention of the issue of sale in this circular indicates that at least the then officials of the Ministry of Health generally have no problem with the issue of the sale of body parts by living individuals, and they have not even attempted to directly prohibit it in their circular for appearance's sake.
That is why, even based on the current regulations and practices, kidney patients’ support associations in the provinces have created a mechanism to receive a sum of money from the kidney recipient and transfer it to the donor. In January of this year, Davud Nowruzkhani, the head of the Kidney Patients’ Support Association of Markazi Province, confirmed the existence of a mechanism to receive and pay the sum for kidney donation, calling it a “gift of sacrifice” from the recipient to the donor, and announced its ceiling of up to eighty million tomans. At the same time, he also confirmed the fact that a financial agreement is formed between the recipient and the donor outside the association’s mechanism, and this agreement in Tehran increases to three hundred million tomans.
The attempt to earn more money by selling kidneys has also caused many sellers from other provinces and cities to go to Tehran and sell their kidneys in this city at a higher price; of course, this is not an easy task for sellers from outside Tehran and also poses problems; because according to the law on kidney donation, individuals can only donate in the same city where they live. Therefore, these individuals are forced to present a formal rental contract for a house in Tehran to prove that they live in this city; which of course is not free of charge and as a result of allocating a part of the sales cost for it, it increases the sales price.
Meanwhile, although the claim of the role of a legal vacuum seems somewhat acceptable from a legal perspective, socio-economic realities show that the lack of preventive law is merely a partial facilitator, and it is economic conditions that play the main role in the issue of organ sales in Iran.
In this context, Hossein Biglari, the head of the Kermanshah Kidney Patients Support Association, implicitly confirmed the role of economic conditions, especially the spread of poverty, in increasing the amount of the "gift of sacrifice" and spoke about the influence of provincial kidney patients support associations in this price increase. According to him, "Unfortunately, the associations themselves increased the price of kidneys; previously, the price of a kidney was eighteen million tomans, but it increased to thirty-four million tomans. In the past one or two years, the price suddenly increased to eighty million tomans. When the price of a kidney was thirty-four million tomans, the parties would agree on prices close to fifty million tomans and the transplant would be performed, but when the Central Kidney Patients Support Association increased the price of a kidney to eighty million tomans, no one would be willing to donate a kidney at low prices anymore."
The organ donation official also confirmed the role of the economic factor in organ donation in another comment. According to him, since organ transplants from Iranians to non-Iranians are prohibited, some donors (read: sellers) go to Iraq to get more money for the transplant surgery and there they calculate the amount in dollars with the recipient; a practice that clearly shows that selling organs by citizens in Iran has become established as a way to earn money and escape absolute poverty.
The sale of body parts is not limited to the kidneys, of course, and some people also sell part of their livers for transplantation to people with liver problems in order to earn money. Reports have also recently been published about the sale of hair, which shows the depth of the poverty catastrophe. According to these reports, some parents sell their children's hair to cover their school fees and food due to extreme financial poverty. The buyers, who are mainly hairdressers and manufacturers of artificial hair, use the purchased hair for cosmetic hair extension procedures; there have even been reports of the export of purchased hair to Turkey and from there to other countries, which shows the depth of the trade in this human product, but its sellers have a very small share of this trade and their goal is simply to earn an income to meet basic needs; just like the sellers of kidneys and livers, whose goal is only to survive; because in such a level of widespread and increasing poverty, no one gets rich with this money.
Source: HRANA
